At fourteen, my pediatrician prescribed me Lexapro to help with unwanted anxieties and trouble focusing, which began when my father was diagnosed with Stage 4 cancer that year. She told me that the meds wouldn’t change my personality, and they didn’t, at least not in any way I could identify then or now. My father died two years later, and I continued to take Lexapro. I saw a therapist briefly during my father’s illness but decided that it wasn’t especially “useful,” and didn’t seek help after his death.

It wasn’t until college that I ran into trouble with medication. During time off, I traveled in Italy with a friend and we found ourselves farming in Sicily. Our host family maintained a vegan diet and used no oil, sugar, or salt. We had no access to alcohol and other vices, and the only caffeine was green tea. I felt amazing, and my nineteen-year-old self logicked that if my father had died three years ago, if I was feeling happy and healthy and in control, then I had no more use for Lexapro. I stopped taking it.

A week or two later, my traveling companion and I went our separate ways and I began to fall apart. I spent two days alone in a hostel in Barcelona before going to see friends further south. Absolutely nothing was wrong, in fact, I was in a dreamed-of scenario of freedom in a foreign country. I could barely move. I cried, I called my mother, I cried, I lay in my bunk, I cried. I read the copy of Les Miserables I’d been traveling with. Finishing the book was its own crisis, true abandonment. I hated myself thoroughly for this incomprehensible and irrational breakdown, and for the replacement of confidence and excitement with sheer terror. In defeat and desperation, I started taking the meds again.

I repeated this cycle of taking medication and quitting flat-out several more times, each time telling myself that I had grown beyond the need for medication and that I was strong enough to cope in other ways that were less scientifically elusive to me, that involved a more understandable “action” than swallowing a pill. The third and last time, during my senior year of college, hit the hardest. Getting out of bed was extremely difficult, and I returned to it at every opportunity. I cried frequently and publicly, chain-smoked, wore the same clothes for days, and had difficulty speaking. Articulating thoughts was nearly impossible. Again, in desperation, I returned to medicine.

It is a challenge to express the absurdity of the school’s psychiatrist. He was a very large (tall-large, not obese-large) middle-aged white man with a name that sounded vaguely like a more colorful sex act. He was inscrutable. I met with him for twenty minutes and answered very personal questions. Some were about my tangible day-to-day, my vices, my sex life, and some were more esoteric, even more personal: tell-me-what-your-brain-is-like-in-five-minutes-or-less-go. When I left, I was armed with new prescriptions for Ativan and Zoloft.

Sitting in that psychiatrist’s office, I felt, viscerally, that I was stripped of the tools I’ve gathered and sharpened for use in my adult life. I felt like a child. It wasn’t the fault of the doctor, there simply was no room for things like fierceness, poise, anger, or intelligence in that scenario. It wasn’t just me, though. Two of my close female friends also visited and received medication from the same doctor, sat in that same stupid office. The three of us swapped accounts, peppered with lewd sex humor and hypothesis about his personal life. The underlying current, though, was that we had solidarity in our bizarre, semi-humiliating experience, and that this man couldn’t possibly understand our brains or our lives. And we all had the same question: am I actually crazy?

It is, of course, a challenge for one person to decide whether or not they’re “actually crazy.” But when there were three of us, all with very different life experiences, we were in a club of sorts–we were “crazy” but that was normal. And if there were two people close to me who had a shared experience of medication, it seemed that there must be others around campus, too. Maybe they could contribute to the electric solidarity, too.

After graduating, I visited a new psychiatrist on my own accord in attempts to get the ball rolling on quitting medication, the proper way. Instead, she suggested I up the dosage of my Zoloft, which I complied with. I don’t know why–again, a moment of defeat, again hope in the authority of…authority. Months later, I let a prescription run too low. I left her a message explaining that I needed a refill, ASAP. When she didn’t reply, I went to her office. The whole practice had moved. The gentleman furnishing his new space took a kind concern for me, leaving a message with the center’s director. How to say, “Oh thank you, I’m actually fine, I have my wits about me, except I guess it’s pretty important that I do get my medicine?” That evening, a co-worker looked online to see about buying meds from Canada, which made me smirk – who was I again? Eventually, I got the prescription I needed from a kind doctor at a walk-in clinic.

I was turned down on my first application for health insurance. I was not granted a life insurance package that would drastically reduce my car insurance, because of one doctor’s inability to supply the proper paperwork. It seems that, on paper at least, I’m crazy, a loose cannon. In real life, I continue to take medication, and am again trying to line up the resources for weaning off in a smart, supported way.

Obviously, my own narrative is important to me, but what continues to tempt me are questions of how my story fits into a bigger picture of women and behavioral medication in the U.S. Symptoms brought on by the illness and death of my father were treated with medications whose management and mis-management propelled my journey down a rabbit hole of depression. In his work Anatomy of an Epidemic, Robert Whitaker asks what if we “uncover a history of a different sort – a history that shows…that psychiatric drugs are in fact fueling the epidemic of disabling mental illness – what then?” The dialogue that emerged for me was not about my father and grief, but about my own mental health – a laboratory for experimenting with how “crazy” I really was. Medco Health Solutions has reported that in the U.S., women are twice as likely as men to use anxiety medication, and that one in four women take some form of behavioral drug. Does that mean that 25% of American women are working in the same laboratory as me, monitoring their moods with vigilance and wondering why they need medication, or if they need it?

Writer and art historian John Berger wrote in his Ways of Seeing, “Men look at women. Women watch themselves being looked at. This determines not only most relations between men and women but also the relation of women to themselves. The surveyor of woman in herself is male: the surveyed female.” The statement is overly simplistic, but I find its hypothesis of a generally heightened self-awareness (the dreaded “overthinking”) in women to ring true. I have begun to discuss trains of thought pertaining to emotion, to identity, to life choices, with male peers trained in the “hard” sciences. I explained the logic behind a particular social choice – my friend batted his hand: “That’s too complicated.” But he didn’t really mean it was too complicated, he meant it wasn’t worth the time to think about it. It was a question of value. No wonder women are “crazy.” It seems like self-awareness and multi-perspectivalism is socially produced, internalized, and then dismissed and devalued once it’s spoken aloud.

Female “madness” serves as amazing fodder for cultural production, popular and otherwise, which would suggest that there is ample dialogue on the matter, among women and men alike. The Rolling Stones released “Mother’s Little Helper” in 1966, and Mad Men nodded to the trope of the depressed fifties housewife in Season 1, when Betty Draper experiences numb hands – a metaphor of agency? – at the peril of her and her family, and is told by a psychiatrist that this is a symptom of psychosomatic stress.

The 2011 period film Hysteria was made about Mortimer Granville’s invention of the first electric vibrator as a tool used to cure female “hysteria” with orgasm. It was a romantic comedy starring Hugh Dancy and Maggie Gyllenhaal. I couldn’t muster up the gumption to watch. I did however, more recently, scramble to see Steven Soderbergh’s alleged last film Side Effects. Its more serious tone and implications of Big Pharm fishiness piqued my interest. What I saw was a film in which a young, beautiful white woman played by Rooney Mara was first the victim of depression, then (perhaps) the victim of the anti-depression medication prescribed by her Jude-Law-psychiatrist, and then in a quick pivot, this same young woman was actually a lesbian con artist scheming with her psychiatrist-cum-romantic-partner Catherine Zeta Jones to screw over Jude Law and take all the money one can get with such a plan. But don’t worry, the scheming lesbians get what they deserve: CZJ is tearfully handcuffed and taken away, and Rooney Mara is imprisoned indefinitely in a psych ward where she is forced to take very heavy doses of some or another form of tranquilizer. I left the movie theater sickened at the haphazard management of the topic, or rather, the use of a topic that is a reality for entirely superficial purposes–you’d think I moved to LA yesterday. Side Effects resolves itself with Jude Law driving off with his beautiful wife and son in a large black SUV. I hope I spoiled it for you.

So where’s the real conversation about women and medication? It is not “good” to be the girl who struggles quietly with vague issues that people seem to know about, nor is it “good” to be the hot mess, the fucked-up chick with a penchant for substances, no matter how many songs are written about that girl. There is a void between the sensationalized caricatures of disaffected modern women and the real women who quietly struggle with common diagnoses that pathologize their internal state, and who weigh the pros and cons of medication.

The stigma of privilege has a lot to do with women’s silence around meds. Affluent, educated women know that they have no right to complain about their lot in life. Indeed, to spend so much time ruminating on one’s own psyche is an indicator of ample resources and leisure. Nothing is wrong, we say. I have everything anyone could want, my problems aren’t so large, it’s not a big deal. This line of thought can be dangerous, because the person devalues their own experience. They exist as a “failed subject” in a privileged medicalized world, and should do their best if not to hide this failure, then at least not to complain about it. But if nothing is wrong, why do we need to be medicated? Am I actually crazy?

The medication entered my life with such an ease in contrast to the ongoing challenges of ridding myself of it, a task that is entangled, as always, with questions of self-worth, normalcy, intelligence, and over-all value–questions that I believe continue to haunt women differently than men. Medicated women are the women of everyday life, 1 in 4 allegedly, so what’s wrong? It’s a big question, but I propose the first step is to start talking. Really. Not in an awareness campaign way, but in a way that allows for the possibility that the “problem” among women with depression and anxiety may not be a problem that should be relegated to the individual. If you take behavioral medication, start talking about it. If you’ve been told to take behavioral medication, talk about it. If you refuse to take behavioral medication, talk. If you take behavioral medication and it’s saved your life, talk about that, too. I take Zoloft 150mg, and sometimes, an Ativan.

Resources, or, Some Great Stuff for Considering Alternative Models of Mental Health:

About Author

Rachel Elizabeth Jones is a reader, writer, and filmmaker who lives and works in Los Angeles. She recently graduated with a Masters degree in ethnographic film, and you can learn more about her work and projects at www.rachelelizabethjones.com.

I've never taken medication for mental health issues, but I think about it a lot.

karenb

there's a recent Backstory (a history podcast – http://backstoryradio.org/shows/all-hopped-up/) that talks about the history of drugs in america and did a segment on the huge percentage of women taking valium in the 60s and 70s – they discuss how the drugs were treating a symptom of women's dissatisfaction with society and their role in it. since you mentioned radio shows :-)

i've never taken drugs for mental health, either, but my partner does, and occasionally gives me the heads up that he's going to futz with dosages – an outside observer can sometimes be useful.

an owl in daylight

I am not entirely anti-med, and I think no one who knows someone who is bipolar or schizophrenic generally can be, but I think—propelled by Big Pharma—we've been taught to have the conversation around medication and particularly anxiety and depression in the wrong way. "If you don't take meds, you'll be sick. If you take them, you'll be fine. Fine, btw, also means never feeling depressed or anxious for any reason."

When I take medication I do not have panic or anxiety attacks. I do not get overly anxious about minor or nonexistent issues. I don't sleep too much and eat too little and wake up multiple times a night. But I get a little flighty and overcommit myself and indulge a bit too much and spend too much money sometimes. I worry when I have something to worry about, and I get sad when I have a reason to feel sad.

When I don't take medication, I have a panic attack when I go to a concert. I spend the day after a party obsessing over every action I took. I lose 40 pounds in 4 months. I get pains in my chest that shoot down my arm. I am very frugal and do not indulge in alcohol or drugs. I get no pleasure in anything. I think about killing myself frequently.

It's not a choice between perfectly healthy and perfectly unhealthy, but it's a choice.

keristars

For me, taking my medicine means the difference between feeling so despairing about life and my future that I don't see the point of getting out of bed or whatever, and being able to say "well, this sucks right now, but if I make just a tiny effort, I can change it" – and then actually making that tiny effort.

It's the difference between being able to apply my CBT learnings to the anxiety I get when I have to make a phone call, or being too overwhelmed by the anxiety to even think about touching the phone.

Taking medicine that works well made me suddenly realize why people cry when they watch movies, or go to Disney World. ..

an owl in daylight

Perfectly expressed.

Story #2

It's interesting, because while I think that is a dominant narrative from doctors ("Take it or you're sick"), and it is a serious problem in the way people deal with themselves, I feel like there are other stories that I hear that bother me equally, and seem equally problematic. I heard voices as a teenager; I tried to kill myself twice (with poison, both times, so when it didn't work I was able to pass it off as general "sickness"), and when I got to college, I got a long and complicated diagnosis with some frightening words in it, and some trial-and-error medication. The thing is, the medication works really, really well for me. I hear voices maybe once a year, and I can brush them off; I sleep; I write; I don't try to commit suicide. And the stories I hear are these: "You're not really sick; you're spoiled and you want attention and you want to think you're special; people who are actually crazy hate their meds and have awful side effects and feel dead inside, or else they're homeless or institutionalized or successfully dead." Nobody says this explicitly to my face, but they say it to my family, or tell me horrible stories about people who are "actually mentally ill." The other story — and it is almost always from men, interestingly — is, "You're not sick; you're a dupe of the Big-Pharma machine. You can't deal with your life so you numb yourself with pills." That one's always direct and to my face.

It's interesting how people want to tell you that you're not entitled to your opinion on your brain — that you literally don't know your own mind.

icebergmama

holy SHIT. I'm glad the meds are working for you, and please imagine me (and possibly my gang of toddlers) scornfully telling anyone who says these horrible things to you to fuck off.

Story #2

Thank you. I am so grateful for how well my medicine works. I wish I had the courage to tell them to fuck off myself, but part of me is always worried that they're right.

dorkmuffin

That's when you get us* to tell them to fuck off.

*Or other rational humans that understand that medication makes a very real difference in some people's lives. But hey, also us.

roxythroatpunch

They're not right.

Thank you for sharing this with us.

an owl in daylight

Thank you so much for sharing your experiences. I have heard these attitudes expressed as well (although never towards me personally) and I agree it's very hurtful to say these things. I think ultimately it's very difficult for people to accept that this is by no means an exact science and individual experiences do not always match up. I think what I was trying to get at is that it's not cut and dry and ultimately what is important is that an individual is able to be their best selves, which may take different things for different people and your "best self" may not be "perfect." But Big Pharma does contribute to this black-and-white mentality towards mental illness, in my opinion.

Story #2

No, I didn't mean to suggest that what you said was at all wrong — just that there are different cultural attitudes even within mainstream American culture; what the doctors say isn't necessarily the thing everybody believes. (And non-mainstream cultural attitudes, at least as found in my immigrant extended family? Also not fun times for me. But that is another story.)

canidoeverything

Oh my god. I (on a lesser scale) know exactky what you're talking about and I'm so sorry to learn that people are actually MORE judgemental when you manage to function despite mental illness. I have Bipolar 1 and though my friends who saw me before treatment and coping techniques would fight anyone who said those things, certain people in my life believe that because I manage to work, be in graduate school, get married, etc. and they haven't seen me "crazy" means that I was misdiagnosed (4 times?!) because bipolar is so popular. I get it. And it sucks. And I'm sorry that your reward for getting "better" insofar as you can seems to invalidate the fact that you ARE actually managing a severe mental illness. I hope that was coherent.

Story #2

Oh lord, bipolar is maybe the worst, especially for people who want to tell you that "mental illness is just a social construct" — diagnoses have risen, ergo the diagnosis is fashionable, so your problems are just a social trend and so they can't be, you know, a force that can destroy your life and send you to the margins of society. They have opinions about why your diagnosis is "popular," so you can't really be hurt or in danger. (I mean, people can argue all they want about madness-as-social-construct, but while they're having that argument there are people literally dying. Not to mention that the people who are busy breaking with reality or can't get out of bed can't really be part of that discussion.)

Anyway, sorry for going off on a bit of a tangent, but yeah, I get you. Here's to our continued survival!

Person

As someone who likely has bipolar disorder (psychologist in a depression study told me to get checked for it because she suspected it but could not technically diagnose me, but I don't currently have the resources to go see a therapist), this frustrates me to no end. The idea that just because more people are finally being diagnoses means that there has to be multiple misdiagnoses is ridiculous! No one stops to think that maybe the reason the diagnoses are going up is because people are actually coming forward about it instead of self imploding or self medicating. And that by having this negative attitude about the disorder they are punishing those who come forward about it.

Lizzzy

I love this article. Sent it to my (psychotherapist, medicated) mother to spread around to some who might need it. I firmly believe that there are some people who *need* help with their brain chemistry. I also firmly believe that there are a lot of people who can and should manage without.

I've been on anti-anxiety meds during some very intense periods in my life and they helped, but ultimately what made my anxiety manageable was stability in my personal life and some growing up. I needed to eat healthily and find my peace by myself and be OK with not being extroverted. I didn't need permanent medication. I could have leaned in and stayed on it, but I didn't and I'm happier for it now.

I wish there were more information available to people about how to replace the chemical calmness with things like exercise and meditation. Over medication is a real problem. Thanks for bringing attention to it.

MamacitaConPistoles

I think the most important thing we can do, after talking about our own meds experiences, is back off and not make generalized statements about "some people don't need" what big pharma is selling. That is probably true. But it's also the business of individual patients and their individual health care team.

I want those conversations divorced from one another until we have some other serious issues on the table and worked out:

Big Pharma and what they sell
The stigmatization of mental illness
The feminization of mental illness
Our societal value for over work and under relaxed (in the US at least)
The failure of our work culture to make room for wellbeing, even if it affects profitability

The last thing people on meds need is to worry that they will open their mouths and tell their stories and hear back that someone in the room might think they are the "some people" who "don't need." The dialogue we are being asked to create becomes almost impossible to have.

For Big Pharma's influence to shift, there needs to be a cultural shift. A huge one. And I support that. But I also think individual patients cannot be made to take on that responsibility when they have other issues in front of them. No one owes anyone (not even themselves) their access to all the mental health resources there are because big pharma profits, or even manufactures contexts of needs.

I've taken zoloft and I am on wellbutrin, adderall, and prozac. I am pretty sure I am functional most of the time because of those drugs. Having a routine and getting regular intense exercise and getting enough sleep and knowing I can see a professional if I need to also contribute. It's possible I could do these things without meds, but I am really not willing to find out whether or not that is true.

Lizzzy

I'm sorry you took my post that way. Of course "some people" was a generalization. I hope you noticed that I said, of course, "some people" including many people in my family need help that goes beyond therapy and exercise, self-regulation,etc. Bipolar and depression run in my family and I *know* that those things cannot be treated without help, using a both/and approach, not an either/or. But I also know, and my saying this shouldn't undermine your points or the author's points, that I didn't need to continue my meds, and in fact continuing made me numb to things that I needed to be aware of. I am absolutely an advocate for mental health. Just a bit taken aback by your reaction.

sednarea51

Speaking personally- you may not have meant it to come off in that way, but what you're discussing (treatment with exercise and meditation) is something that has been recommended over and over and over and fucking over to many of us with mental illnesses, and after a while it gets hard to say "I'm glad that worked for you, but it does not work for me" for the five zillionth time. Because, you know, if we were stronger, better people, we would be able to fix ourselves without resorting to drugs. Also? It can feel like someone is saying "It'll be okay! Put a band-aid on it! Walk it off! What are you, some kind of pussy?" when you've just lost a limb. Again, that may not have been your intent, but I think in an area that's so swamped with "only weak people need medicine" messages, it beehoves us to be very explicit about intent.

Also: "there are a lot of people who can and should manage without". So you get to decide how other people choose to deal with life?

MamacitaConPistoles

I agree. Your experience of illness is not any less real because it is not the same as my experience with illness. What worked for you worked for you, and it might work for other people, and that will always be valid information in these conversations.

But I really appreciate how sednarea51 frames this issue. The exercise, diet, meditation therapy is not actually news for lots of us. And, although it is entirely possible that mental health meds are over-prescribed, it is also the case that they are also still heavily stigmatized. At the same time, the exercise, diet, meditation therapy option is not really taken seriously- it is framed as "walk it off, you lazy chump" in the subtext of this discourse.

That stigma means that there are people who should probably be on these drugs and aren't, even though there are likely people who are on drugs and don't need to be. In the same way, it means that patients might not actually be using alternative therapies as effectively as they can, because they aren't considered to be real treatments.

Given all these issues, I would much prefer to see this framed as "health care providers– and insurance providers– should take alternative therapies seriously. Those options should be incorporated into supervised treatment plans. This will allow patients and doctors to explore a spectrum of treatment options. Among these are "drugs without stigma" and "alternative therapies that are actually meant to be effective therapies and not codes for 'walk it off.'"

hellebore_

I love how you frame this, and also the way you emphasize that we all have different exepriences with these issues and shouldn't over-generalize from our particular situation and reaction. So, not generalizing to anyone else, just sharing my experience.

I had serious situational reasons (grief combined with the need to care for a fatally sick hospitalized person) that caused my initial prescriptions: zoloft and lunesta, cycled through that and wellbutrin, trazodone, klonopin. At the time it helped me stay functional and care for the dying person, and keep myself together — especially when my long-term partner left me for being "too sad" in the middle of it all. But after the initial situation was past, there was never any discussion of tapering down or going off the meds. My psychotherapist just wasn't interested. I finally saw a new psychotherapist who took me off some of them because he said one could stop breathing at night (!!) with the particular combo I had. Another thing the first doctor hadn't known/mentioned.

I ended up tapering off the meds myself because the other doctors I saw as part of my health plan mostly ignored my questions & requests. Luckily I had a great talk therapist the whole time, and I even talked about it with him in addition to my friends as I planned out my own tapering-off program based on research I did. It went 100% fine. I barely felt any difference — a little vertigo the first week or two, then nothing. It's been 3 or 4 years now. I still continue with and love talk therapy (which is *not* CBT, which I've personally always found loathsome). I also did weekly acupuncture for anxiety and related digestion and sleep problems for about a year while going off the meds, and that was amazing — immediate effects and so much more powerful and positive than the meds I'd been on. The strangest part about the meds was how little I felt when I went off them — it really made me wonder how much more than a placebo effect they had been giving me (again: me, personally, with my body chemistry). Sometimes I wonder how much this side of the story is told — that the drugs sometimes aren't so powerful, aren't much more than a placebo. I also wonder why it is so hard to get doctors to begin the conversation of tapering down — why it's left up to us as patients so much (the experience of my friends bears this out too). I could have been paying money for that medicine for ages, and could have gotten really dependent on it, if I didn't of my own volition take myself off, and it wasn't in any doctor on my health plan's interest to help me figure out if going off was a good idea or not.

vanessa steck

right. it can be a placebo, or it can be something that helps if you have situational depression. but if you have longterm biological depression, then meds might actually be the difference between living and dying, and you know, i've heard about diet and exercise enough, thanks.

icebergmama

I've tried dealing with my depression-ish stuff (I haven't actually been diagnosed but from what I've heard/read, it sounds like it) via therapy, and via DIY methods like self bribery, but I'm actually on the brink of considering medication, so this was timely. According to a friend of mine everyone she knows with toddlers is taking or has taken some kind of chill pill or other; I didn't want to start there, but it seems like it might be the thing I need.

Taking care of the people in yo life necessitates taking care of yoself. If you think they might help, look into meds! Or therapy! Or anything you think could be helpful.

MamacitaConPistoles

Those kinds of meds can be really effective in short-term, not-forvever cases of situational depression, stress, or anxiety.

If you're not feeling like you can bring your A (or B or C) game right now, ask a pro to talk over your options with you. At this point, it's an exploration and not a commitment.

Taking care of yourself is a really good priority.

vanessa steck

i mean it saved my life. so. there's that.

CatFoodParty

I was prescribed Prozac a few years ago. I took it for about a year and a half and then my script ran out… and I never called in to get a new one. I was taking 40mg of prozac andi t did NOTHING. I was still anxious and had panic attacks. So I stopped taking it because, shit, I could experience all of that without paying $15/month.

lucy

Me too! I've taken 5 or 6 different antidepressants/anti-anxiety meds and they all may as well have been placebo (and I didn't even get a placebo effect). I even got prescribed ritalin when the person I was seeing had no idea what else to give me, and that had no effect that I ever noticed. It sucks that I also can't do talk therapy because my social anxiety is so bad that I literally cannot talk (I tried for so long).

heidi ruckriegel

Lucy, have you considered an online course/treatment for your anxiety? I suffered from PTSD after a long-term abusive relationship and found I also literally could not talk about it. But I was able to write about it and this really helped. http://www.anxietyonline.org.au/about-us is one course, I did a similar one but this was only for Australian residents. There are also psychologists who treat via email. Good luck! I got better, but it took time. I still get quite down sometimes and find old bad thoughts coming back but I can deal with it much better and more quickly.

keristars

I've been officially clinically depressed for so long that I don't know what it's like to not always have that in my head. I mean, the last time I remember not wanting to sleep all the time and wasn't hung up with anxiety all over the place or fighting a lack of self-confidence, I was in elementary school. They started me on meds when I was in high school, and Effexor ended up working okay (it taught me to recognize "hungry", at least), but the side effects if I was just thirty minutes late for my dose were unbearable. And I hate taking medication, so I resisted and resisted.

SSRIs either do nothing (I was on Lexapro for years and years, but it was such a minor difference it didn't matter in the end) or gave me really bad side effects. I did a clinical double-blind study 2 summers ago in a test for Savella for treating depression coupled with severe exhaustion, and I was convinced that I was getting the placebo, except that my reporting scores actually improved and I wasn't exhausted all the time for once? So after the study, they tested me out on different SSRIs, and then finally Savella (an SNRI) when those proved to be no good, and they did this for me for FREE even though I didn't have insurance. And you guys after two months on it, there was a distinct difference. Then six months, a year… and I started to become acclimated to it. There's still a HUGE difference when I don't take my pills regularly (like, even when I say "This time I'll be okay!" and actually make an effort to be okay, it's hugely obvious days later that I'm not), but it's not the same as last year.

I'm so scared that Savella is going to stop working for me entirely. And my insurance is changing and it's about to go from $35/month to $85/month, when I can't even afford rent, because of astronomical student loan bills. A lot of SNRIs and other meds have such terrifying side effects, and I'm so happy that Savella works for me. Except it isn't anymore. And my mom has got it into her head that my nearly-year-old dysautonomic conditions is due to Savella side effects, but my googling doesn't suggest that, and what if it is?!

… maybe I should try seeing a psychologist about this, but I don't know if I can afford one, or if I want to expend the effort and Getting To Know You sessions. I hate them, even as I need someone to talk to, because I always feel compelled to lie and tell the shrinks what I think they want to hear, so I never really get accurate advice/help. :/

MamacitaConPistoles

Oh lord. I am so sorry you are carrying that worry. I wish you could just focus on the solution to the wellbeing problem and not have to worry about the money part.

keristars

Thank you.

I got really embarrassed that I posted all that, but I guess the feeling bubble inside got burst with this post. I appreciate your reply so much!

Daniel_Loo

Hi keristars,

I'm a pharmacist, and I'm hoping that maybe I can be a little helpful.

You may be able to get some free Savella, so it's worth looking in to if you haven't yet.

I'm not sure if you've tried any other SNRIs, but there are a few others that might be cheaper – Effexor, which has a generic, or Cymbalta, which has been around longer and tends to be on a lower co-pay tier with many insurances.

I hope this helps, and good luck.

keristars

Thank you!

I'm a little late replying because I got really embarrassed that I posted all that – I guess the feelings bubble inside me got popped when I read the original post. People have mentioned the assistance thing to me before, but I really had no idea where to start with that, and of course the depression means making the effort is difficult to do! (It took me over a year to even start the process that got me on the clinical trial, even.)

I was on Effexor in high school, but it didn't help as much as Savella has (though it could also be an effect of the decade of therapy in between), and the withdrawal symptoms were horrible if I was even 30 minutes late for my dose, so I've been very reluctant to do another SNRI. But I'll bring it up with my doctor.

Thank you so much, again!

sednarea51

I think this plays into the fact that Western medicine is- I would argue- pretty sub-par at managing illnesses in any way that doesn't involve medication, and as a knock-on effect, our insurance system is reluctant, to say the least, to provide support for non-medicative treatment. Exercise and talk therapy are important elements in managing depression- indeed, everything I've read says that you have to pair an antidepressant with talk therapy to get the optimal effect- but it's substantially more difficult to get reimbursement for therapy than it is to get a script for Paxil. And forget about getting help with a gym membership to help treat depression. Now, as a reasonably well-off person with health insurance and savings, I could choose to pursue those additions to treatments on my own, but if I was on Medicaid?

(Disclaimer: I'm been on Paxil for 16 years and I think it's kept me safe from myself at least once; I also work in clinical research.)

I've struggled chronic depression and anxiety for most of my adolescent and all of my adult life, being that privileged educated white woman with no "real" problems to speak of. I've tried to come off the meds, and would love to never have to take them again thanks to diet and exercise and meditation or whatever, but that's unrealistic when you consider that mental illness among the women in my family runs rampant: great-grandmother, grandmother, mother, aunt, sister.

I am not ashamed of the fact that I take Wellbutrin and Prozac daily with the occasional Klonopin for attacks. I'm embarrassed I waited as long as I did to see a psychiatrist and get my medication adjusted and realize just how bad I had gotten after months of convincing myself that it was just hormones or lack of sleep or whatever we tell ourselves to make us feel bad about having nothing to feel bad about.

My brain doesn't work right without these medications; my quality of life is improved thanks to them. I am lucky enough to be able to afford insurance. I would love to stick it to big pharma, but I'd also like to be able to find some semblance of happiness and normalcy instead of being unable to get out of bed, to let myself be seen in public, to sleep for fear of my body shutting down, to be alone without wondering if my partner has died inexplicably.

I don't want to have to take this medication for the rest of my life, but I've come to terms with the fact that I might have to.

vanessa steck

well said. i wish i didnt think i would be on SSRIs for the rest of my life, but i almost certainly will be. and you know, whatever. if it keeps me alive? that's cool.

also i will point out that not everyone CAN practice the exact kind of "lifestyle changes" that the General Commenteriat things that we should be practicing.

Yet To Register

Hysteria is an immensely shitty movie, so no one is missing out on much if they skipped it.

mittenstheboar

Isn't idea kind of a rip-off of In the Next Room? I mean, I guess you can write about multiple historical moments without it being a rip-off, but it sounded weird to me.

anachronistique

Hugh Dancy's face is really cute in it, but it's so not worth watching just for that.

Whitney

I'm bipolar and have been successfully on medication for it for around four years, but I recently did the thing I think almost everyone on long-term psychiatric medicine does, where I went 'oh, I feel great! I feel just fine on [X]mg of my brain pills, so I should be fine on [X-50]mg of them! That'll give me more wiggle room if I start to feel bad! And I won't have to cut a pill in half every night!' Yeah, don't do that. Not without asking your doctor. That wasn't a good time.

Almost everyone in my circle of lady friends is on medication for varieties of depression, OCD, and anxiety, and they are all very, very glad that they got on them. My friends who all take Lexapro call themselves Lexabros.

dorkmuffin

LEXABROS! Oh I love it.

MamacitaConPistoles

I've said for ages that psych meds sound like superheroes and their sidekicks.

IN THIS ISSUE OF LEXABROS…

PAXIL AND HIS SIDEKICK PROZAC VISIT THE HOME OF THEIR MENTOR, THE MIGHTY TEACHER ZOLOFT!!!

Whitney

Side by side with the vivacious vixens Ativan and Klonopin!

MamacitaConPistoles

And kid sister, TAMAZEPAM!

Whitney

Abilify totally sounds like a superhero name already, doesn't it?

My personal hero is LAMOTRIGINE! THE DIAMOND DARLING!

Trixie

I am 30 years old, and started Lexapro at age 22. I too have tried many different combinations of medications, and going unmedicated. I cannot say that I am anti-medication, but I am concerned by what seems to be a general trend in medicine: Treat the symptoms, not the patient. If you take the pills you will get better.

I think the greatest progress I have had in my 8 years of pills and therapy was accepting that the pills are not the cure; they are like crutches. They help me stay stable enough to work through my problems the old fashioned way — by working in therapy to recognize my destructive behaviors, and work to learn new, healthier behaviors.

I like that Ms. Jones talks about de-pathologizing mental illness. Let's have that discussion please. But let us acknowledge that pills alone are not any kind of answer.

figwiggin

I just started therapy for depression and was supposed to see a psychiatrist on Monday to talk about possible medications, but then he canceled on me and the receptionist lost our phone connection before she rescheduled me, so. I feel nervous about taking medication, and even moreso now.

icebergmama

Oh nooooo. call them back figgy! I will internet-hold your internet-hand.

NicoleCliffe

Medication can be transformative and amazing, and I hope you connect with a good psychiatrist and feel really well looked-after.

MamacitaConPistoles

Oh man, that is the absolute not great thing to have happen to a person trying to get going in this area of health care… :(

It's just a medication. It won't magically solve anything, and it won't make you less you. If it works, it will take the edge off whatever is making you feel crummy, so you can engage all your other resources to get through your Grim.

The real magic is in the resiliency and creativity of humans in coping with their problems using all the tools available to them. That part will come from a place that is inextricably you, and it will always be you. The meds will hopefully just make it a little easier.

fondue with cheddar

Congratulations, you've taken a huge step! You should definitely call back. Don't feel nervous about taking medication. It isn't a magical cure-all, but sometimes all it takes is a little nudge to give you the strength to help yourself. And if it doesn't work for you or you don't like the way you feel on it, you can always switch meds or stop altogether (under a doctor's supervision). Medication is a boon for a lot of people, and you may very well be one of those people. But you don't know unless you try.

karenb

does someone with more personal experience than me want to chime in with cognitive/behavioral therapy thoughts? from what i've seen, CBT is pretty crucial in tandem with balancing chemistry, but i don't have personal experience to speak to it.

NicoleCliffe

I have a relative who swears by CBT.

an owl in daylight

CBT honestly saved my life. Medication is key to managing my depression and anxiety, but CBT (and EMDR, if we wanna get really out-there) helped me deal with a lot of the unhealthy coping mechanisms and negative beliefs that I developed due to my biologically-based issues and a couple of not-great events in my life. My therapist marvels at how different I am than when I first started treatment with her (I had been taking medication for years without therapy at that point).

Sara

Saved my life as well. Repeatedly. I've been working with CBT (and versions of it that go by different names) for years. I've been resisting medication for years because I dealt with infertility for years (also not helpful for depression and anxiety) and did not want to deal with going off meds while pregnant (ever hopeful). I've since had a baby and am still breastfeeding, but I may consider meds when we've weaned. My anxiety still gets the best of me some times and it's a struggle. I had an extremely difficult episode a couple of years ago and I returned to therapy after a number of years without. Learning ways of transforming negative thoughts instead of going repeatedly down the very dark rabbit holes has been life-altering.

mandolin

Oh my gosh EMDR seriously is the best. And then I try to explain to my friends what it is, and I sound super strange. But yes, EMDR plus Wellbutrin has been the only thing that finally let me leave me house, go to work, sleep at night… I am so glad after about 8 years of trial and error I have finally found a routine that works for me, and am stable enough that even when I have a bad month, I know how to deal with it (CBT!)

clever_animal

EMDR! Especially if you are healing from trauma, try EMDR. It completely changed my way of thinking; it didn't cure my depression but it made living with my past feel like NBD and helped me focus on improving my present. It sounds super woo-woo and hand-wavey and at first I didn't want to try it because I am a Serious Rational Person, but much to my surprise EMDR is backed up by research saying it works. Nobody really knows *how* it works, but then we don't really understand a lot of things about the brain. The great thing about talk therapy methodologies is the worst side effect is … you waste an hour of time. Low risk, potentially high reward. Therapy for everybody! (No but seriously I think people should have access to therapy as a standard part of healthcare. And everyone should have access to comprehensive health care for free. FFS America).

sednarea51

The best analogy I can think of for depression is that it's like clinging to the walls of a pit; it's cold and slick and awful, and you'd like at some point to climb your way out, but you're spending every last bit of energy you've got trying to hold onto the walls. It's too terrifying to even think of moving. In this analogy, medication is a rope someone throws down to you. A therapist's job is to call out encouragement from the top- to talk you through putting your hands on the rope, warning you about slippery spots, teaching you how to get your feet under you for a better grip and asking if you need a rest or a flashlight. They both have a role. Hopefully medication keeps you from slipping back, or slipping back too far; therapy teaches you how to avoid the edges when you can and climb your way out when you can't.

MamacitaConPistoles

I've always thought of it as trying to swim across a lake, but swim across a lake while under a wet duvet. Your speed is inhibited by the fact that it takes so much effort to get your head up to breathe.

But I think the wall analogy is even more accurate!

fondue with cheddar

Those are both really good analogies.

I read one in a book that really spoke to me. It described depression as a vine that grows around a tree, stifling its growth, and after awhile it's hard to tell where the tree stops and the vine begins.

Abanthis

One data point: CBT can be very useful, but it is possible to be in too low a place to benefit properly from it (which is where, for me, medication comes in), and it doesn't suit everyone best.

It's a very top-down approach; a friend of mine on her blog put it as (using the depression=fog/storm metaphor) "After a while of living with depression/anxiety it can become difficult to believe that other people live life in the sun; these people don’t understand why you are always cold and pale, and you don’t understand why they have a tan. CBT allows you to remember that the sun is out there, but it doesn’t necessarily allow you to feel its warmth." I personally find that you can apply logic to feelings, reactions, and associations as much as you like, but parts of mental illness are by definition irrational. The self-analysis side of things is very valuable, though, and any therapy is far, far better than none.

I personally, and purely by chance, have found hypnotherapy useful as a more bottom-up approach, rewiring your more subconcious ideas. Yes, yes, I know it sounds like a complete load of balls, I spent most of the first couple of sessions internally going "this is so dumb" and yet still managed to get enough use out of them to keep going back. It's very similar to meditation, really. So, hypnotherapy is what I've seen most tangible improvement during, so, one data point, people might like to give it a try.

anachronistique

As someone who really loves lists, logic, and talking myself into and out of things, I found CBT very helpful. It gave me structures to use when I was feeling low or on the self-hatred or catastrophizing spirals. I don't think it will work for everyone, but it did for me.

Trixie

CBT is very helpful for some, and is the most common form of talk therapy. However there are a number of different kinds of therapy beneficial to different populations. Some swear by Dialectical Behavioral Therapy (DBT) for Borderline Personality Disorder (BPD). Still, DBT does not work for every person with a BPD diagnosis. I say look in to what sort of therapies are available, and think about how each might work with your learning style and personality. Good luck!

<3 u marsha linehan

DBT is definitely not only used for people with BPD diagnoses. It works for lots of the various symptoms, in various intensities, that lots of people without DBT diagnoses have. Emotion regulation, mood lability, impulsive behaviors, dysphoria, black-and-white thinking, anxiety and fear of abandonment, trouble with sense of self–DBT can help improve all that stuff, and lots of people experience these things in lots of ways.

Also <3 your screen name. At my old job, our therapists provided DBT therapy (individual and group) to women coming out of prostitution. Marsha Linehan came and did a two-day training with the full staff and it was the best two days I spent while I was at that agency.

It's an option, commonly used and I think it's been effective for me. Basically the notion is that depression is not an on/off switch, it's a process, and by recognizing the elements of that process and counteracting them we can treat depression. For example, basic CBT is really useful for identifying ruminative thoughts (negative "broken record" thoughts that are endlessly repeated, causing progressive wear and anxiety) and developing ways of defusing them. It can be a powerful treatment when used in tandem with drug therapies targeting the neurochemical causes of depression.

CBT didn't work for me at all. It frustrated me a lot. I'm smart and a very robotic thinker, in general, so I seem like an ideal candidate, but it all just seemed too simplistic, which bothered me and made it not helpful. Possibly I got poor CBT. Possibly therapy just doesn't work for me.

Ultimately, it is drugs that work for me. I've been on dozens of drugs that did nothing and therapy did nothing for a long time. Once I found a good therapist, it helped me sort through things, so I wasn't ruminating on them and depressed by them anymore, but I was still every bit as depressed and anxious as I had been. But all of those "issues" were really things I made up early on in my depression; I found it easier to cope if I thought I had reasons to be depressed. So therapy got rid of those artificial issues and I am back, after many years, to a sort of content-less depression, which is weird.

Even though drugs are what work for me, they aren't perfect. Effexor is the best, but it needs some help from Lamictal. Sometimes I still nosedive and need an antipsychotic. Combinations that worked before don't always work again. Stupid brain.

paige

I took Zoloft, 150mg, for almost a year. I started taking them because my depression grew so great that I literally (yes-literally) felt that it was a black shadow monster that lived right outside my peripheral vision. It was scary, and I never admitted that it was there. I remember sitting in my therapist's office and finally saying the words "I think I'm depressed," then looking over my shoulder. It was the lowest I'd ever felt – no amount of exercise, talk therapy, light therapy, or any other "YOU SHOULD JUST DO THIS THEN YOU WON'T FEEL SO BLUE" suggestion was helping.

I firmly believe that medication (paired with weekly talk therapy) helped me get through that scary period. After about 10 months, I ran out of pills while on vacation, went through a disorienting withdrawal period, and haven't needed to go back on pills. Because I was being managed by a therapist and a psychiatrist, I have a lot of tools at my disposal now for managing my "sad" feelings. But, I remember what it felt like when I reached the point of needing medication – how scared, disoriented, lost, disconnected I was. I will forever be watching myself for that side of me.

It's exhausting.

paige

I took Zoloft, 150mg, for almost a year. I started taking them because my depression grew so great that I literally (yes-literally) felt that it was a black shadow monster that lived right outside my peripheral vision. It was scary, and I never admitted that it was there. I remember sitting in my therapist's office and finally saying the words "I think I'm depressed," then looking over my shoulder. It was the lowest I'd ever felt – no amount of exercise, talk therapy, light therapy, or any other "YOU SHOULD JUST DO THIS THEN YOU WON'T FEEL SO BLUE" suggestion was helping.

franceschances

Sympathies. I also had depression hallucinations. They were of guns pointing at my head. That I would go to class and try to ignore because oh you know, it's just me, it's not that bad of a problem, I don't want anyone to *worry* about me! Luckily I now recognize that this is no way to live thanks to lots of therapy and 100 mg of pristiq.

logicbutton

I had something similar during a long depressive episode six years ago. It felt as though there was a separate entity in my head, taking up space and speaking to me in a voice I couldn't quite hear. When I went back on Wellbutrin (I've been medicated on and off for the last fifteen years), the effect was of the medication physically shrinking the entity and pushing it aside. I've never heard of other people having that experience, so thank you for sharing yours.

franceschances

This is such an important conversation to have, thank you. Something else I always have to wonder – are depression rates so high because we actually are sick? As in, something in the way our world works makes us sick and think that not living in it would be better? The world is a pretty messed up place, I wonder why this train of thought isn't taken more seriously. (jk I do know – spoiler alert, the answer is all the powerful actors who benefit from the status quo)

MilesofMountain

I probably don't really count as a depressed or medicated woman, but a few years ago I found I was having trouble dealing with stress and under a bit of a "fog" of sad emotion constantly. I moved, got a new job, dumped my unsuitable boyfriend, and felt fine for almost a year. Then I couldn't seem to make new friends in my new town, I started feeling underappreciated and overworked at work, and it all came back. About a year ago I started self-medicating with St. John's Wort, and it's definitely helped (when I remember to take it).

I sometimes feel like the fog is thinner, but still there, and I know I should see a psychologist about it, but the only one I could find in my small town specializes in children and I don't think she'd be very helpful. Especially because I'm not really sure how much of it is legit emotions and how much is improper brain chemistry: I still don't have many friends, I don't like my job now, and maybe if I just moved and changed careers and dumped my boyfriend I'd find I was just fine again.

karenb

I am glad you found something that works for you! I take a B Complex to help with PMS, and I love it. Public service message, though, be careful with the St Johns Wort, it has been known to lessen the effectiveness of some types of birth control.

Also, if you're finding the fog creeping in, maybe that local doctor could refer you somewhere more appropriate, and help you work through your situation, and sort out if it is your brain or your circumstance or a combo of the two.

Daniel_Loo

I would like to second karenb's public service message – and not only can St. John's wort decrease BC effectiveness, it interacts with TONS of other medications, both rx and OTC. So make sure to mention that you're taking SJW to your pharmacist if you ever pick up meds.

alkali

To draw a weird analogy:

I used to be irritated by descriptions of bariatric (gastric band-or-bypass) surgery, thinking that people who were choosing that surgery should just try to eat less and exercise more. At some point, I realized that clearly that wasn't working for them, and I shouldn't be annoyed at people for doing something that worked for them and that made their life better, just because in my head I had some aesthetic preference for some other kind of treatment. Improving their lives is a lot more important than upholding some idealized mental picture I may have of what their medical treatment should be like.

I try to think the same way about medication. Everyone, and I include myself, has a bunch of preconceptions about psychiatric meds, maybe including suspicions of Big Pharma, half-remembered bits of One Flew Over The Cuckoo's Nest, and some ideal dream of living a pure and natural life without "toxins." But at the end of the day either a medication will really work for someone, or maybe it won't, in which case maybe another one will, or maybe none will. And if there's something that works for someone, great, and that matters a lot more than getting hung up on some ideal dream about how people with mental illness ought to go through their life.

(Full disclosure: Buspar, 1999-2000)

eiffeldesigns

I had the same thing re: bariatric surgery. Until my best friend went through with it. I saw how she struggled. And how hard she worked. And how hard she still works. Bariatric surgery is not an easy path.

alkali

I'm sure you're right that bariatric surgery is not easy (I've heard the same). But I'd add that even if it were easy, that's OK! It's OK for people to hope for easy solutions to illness! "What, you want to take a pill that makes your crippling anxiety go away?" Yep, exactly. Bingo. That's just what I want.

Now, in point of fact, I don't know anyone who's had a completely easy time with psychiatric meds. But our collective preconception that there's something illicit or lazy about trying to medicate a medical condition — that people should somehow have to "earn" their way out of illness — is worth fighting against.

logicbutton

I've taken Sertraline (generic Zoloft) 100mg for the past two and a half years and it's more or less saved my life. I took Wellbutrin sometimes as a teenager and new adult, and it worked decently well, but whether because I was still developing or because it just wasn't the medication for me, it didn't give me the epiphany that the Sertraline did about what it means to be happy. Seriously, it was like, "oh, so THIS is what joy feels like!"

eiffeldesigns

Wellbutrin/Buspar/Klonopin

I recently came to the conclusion that I am going to not bother going off my meds. For a very long time I played the same thing in my head, "I can feel happy without all these stupid chemicals!" But. Alas. I do not think it is meant to be.

I may be on medication for the rest of my life. But if it means I can ride the train without turning into a puddle of tears because it's too crowded (hi, panic attacks, you are a mega bitch), not start to twitch uncontrollably because the boyfriend wants to go into a different train car than you usually do, because he's not insane (oh, ocd/anxiety, you are also a fucking asshole), and actually be able to get up every day, wash myself, leave the house, and not leave soda cans strewn on the coffee table because it is just. too. hard. to clean up (depression, you too, are a prick)? I will do it. And I will take them every day. Without fail. Because to not do so would be debilitating.

But not fucking Lexapro. That shit made me gain 40 pounds.

Amphora

Buspar! High five for anti-anxiety medication (the doctors I see haven't even heard of that one, for some reason it's all about the short-term Xanax these days). I have been taking that and Effexor for six years and have no plans to stop, because um, it's working.

Fang

This is super timely, since I just started a Ph.D. program at an R1 university whose included-in-funding insurance is much MUCH better than the insurance at the (less good, and in a small and nosy town) university I just left. Yesterday I walked into new university's counseling department and told them I'm having panic attacks and need help managing anxiety and want to talk about medication.

I know that part of the anxiety is grad school, especially in the humanities: these days the act of pursuing academia feels like tilting at windmills. But I also know that LITERALLY GIVING YOURSELF HIVES FROM STRESS is not normal, and neither is your arms aching for hours after sneezing while holding a steering wheel because your shoulder muscles are so tight. Both of those things have happened for me in the last year. And I can feel my anxiety spooling up already, and I know that by mid-late October it's going to be bad again.

The very nice psychologist who did the intake appointment with me (seriously you guys, new university's counseling and psychological department is SO GOOD) asked if I had any misgivings about medication or talk therapy and I told her that I used to, but not any more — these days it's like going to the mechanic when something's wrong. But I also told her that I didn't feel safe pursuing mental health solutions in the place where I just came from, and she said that was totally understandable. I am all for talking and reducing mental health stigma, because the only reasons I can look at it as taking my brain in for a transmission flush or whatever are that 1) I am in a much larger/more progressive/healthier community and can trust that they've heard of HIPAA here, and 2) my insurance is SO MUCH BETTER. It's outrageous that not everybody has these options.

Abanthis

Oh wow, yes, academia can be a very tricky environment for mental health issues -on the one hand, it's always intense and normalises -even glamorises- stress in a stunningly unhealthy way, on the other hand there's the degree of flexibility and acceptance of eccentricity which can either help people with problems or hide those problems while they worsen.

dorkmuffin

I have to come back and spend more time with the comments here, but I wanted to post a link to an interesting piece the NYTimes ran recently about the lack of major psychiatric drug developments in pharma:http://www.nytimes.com/2013/08/20/health/a-dry-pi…

I think it's important to note that a lot of psychiatric medications are still unknown quantities. We know that they act on a specific pathway (well, sometimes we don't know but we THINK they do) and that it produces some noticeable effect in some percentage of people with a specific problem, but beyond that there is a LOT of work to be done. I'm oversimplifying, of course, but at least for me a lot of the frustration with psychopharmacology is that there's still SO much we don't know.

Also, folks interested in depression and its treatment/everything should check out the Noonday Demon by Andrew Solomon. Fascinating read, basically a long-form New Yorker article.

MrsTeacherFace

In college I went through a pretty terrible break up, first love and all that, cheated on, etc. and I was having trouble sleeping and eating, just heartbroken and sad. I lost about 20 lbs before my mother insisted I go see a therapist, and when I did he talked to me for about 20 minutes before recommending that I start taking Wellbutrin.

I wanted something to help me sleep, maybe, but not something to make me less sad when I was sad for a genuine reason. This wasn't about brain chemistry; it was about genuine situational sadness and loss. I refused and never went back and eventually, in time, recovered and got over my heartbreak. I hate to think of what I would have gone through if I had begun taking Wellbutrin regularly when I didn't need it.

I know there are people who genuinely do need medication, and they absolutely should get help, but not everyone does.

alkali

I hear what you're saying and glad that worked out without medication. However:

I was in a work situation a number of years ago that went horribly, disastrously wrong. I went into a tailspin of anxiety where I could barely get out of bed and occasionally had anxiety attacks (in public, too, which was fun). Did I have genuine reasons to be anxious? Oh my yes. Did the anti-anxiety medication that my shrink prescribed help? Oh my yes. I don't know what would have happened if I hadn't been able to turn down the volume on that anxiety a little. As it happened, I got a new job, the anxiety went back to normal, and I was able to get off the medication.

It sometimes makes sense to medicate situational stuff. If I twist my ankle on a rock while running, that doesn't mean there's something intrinsically wrong with my ankle, but I might take Advil for it all the same.

practical cat

"If I twist my ankle on a rock while running, that doesn't mean there's something intrinsically wrong with my ankle, but I might take Advil for it all the same."

I understand why this article was posted, but at the same time it would be nice to not have to constantly justify myself to the world as to why I'm treating my severe chronic illness with medication. Nobody's ever questioned why I chose certain treatments for kidney failure or hypertension, but I see articles asking questions like this about mental health every few months.

Amphora

It would be nice if primary care doctors who have talked to one or two drug reps would refrain from handing out prescriptions for powerful medication without so much as suggesting a referral to a psychiatrist, let alone a therapist, as IF it's something as straightforward as hypertension that can be monitored at a follow-up appointment. Then maybe we wouldn't need to be having this discussion.

sednarea51

You saw that I mentioned major organ failure, right? Remind me how that's straightforward?

And why are you making the assumption that PCPs are universally being duped into doping up their patients by evil underinformed drug reps? Or does that only happen with treatments for mental illness?

Amphora

Not sure I understand why you're pushing that point – I specifically didn't mention it. But yes, any primary care doctor would know to refer you to a specialist immediately, so again, my question is why isn't something like depression handled the same way across the board?

sednarea51

I'm pushing that point because they're both major chronic conditions that impact my life and that are difficult to manage, but I only have to justify getting continued treatment for one of them. And I agree that any complex illness- which can include both depression and hypertension- should be appropriately referred to a specialist for management. What I don't understand is the constant second-guessing of standards of care for a complex and chronic illness by the general public. As I said, I don't have to read editorials on how I should treat my other chronic diseases; why am I constantly reading them on how to manage my depression? Why is that different?

Daniel_Loo

In pharmacy school, we were actually taught to view psych disorders as something like hypertension – just like how some people are born with high blood pressure, some people are born with brains that are a little off. And just like I take medication to help my BP, some people need to take meds to help their brains. You treat depression just like you'd treat any other disease.

Kelsey

Individual psychiatric meds are the way that our culture deals with a macro-level problem of society being sick and it's a crap way to handle it. When certain percentages are so high (such as the 1 in 4), there's definitely a bigger problem that needs looking at. Unfortunately, we're in a holding pattern where being on a just barely even enough keel individually is seen as healthy.

That said, you can pry my brain meds from my cold dead hands. I am abjectly terrified of being without them. The cycle of stopping and starting meds is never one that I've engaged in and it baffles me a bit. But I wished that the ones that worked on my brain didn't have to be balanced out by other medications so that I can do things like eat and sleep. (Wellbutrin, Lexapro, citalopram, trazodone, Synthroid.)

MamacitaConPistoles

YES. THIS. If 1 in 4 people has a condition, something is up in the whole card game of society.

That doesn't change the fact that people who need mental health drugs are playing the hand of cards they are dealt in a game where they have only limited control over anything other than themselves and their own choices (and those are constrained, too!).

This is wonderful. So true about the guilt when there's nothing "wrong" with your life.
I was on Effexor and it helped until it didn't. Now I'm on Lexapro and Luvox and I'm OK. Not good, just OK.

noodge4lyfe

This story really spoke to me (as it's clear it spoke to others too…) and for good reason. I've had many dialogues with other women who have struggled with this.

I had a really effed up family life with depressive, suicidal, substance abusing parents. I then went on to a marriage that was abusive. During this time, I always focused the reasons for these problems on myself (self-awareness) which was consistently supported by those around me because – let's be honest – who wants to be targeted as the reason for obvious dysfunction? It's way easier for someone who is in the habit of taking the blame to continue to do so.

When I went through several unsuccessful fertility treatments (yes, with my abusive husband), I found myself in a deeper depression than I had ever been. My existing therapist had already diagnosed me with ADD, and then with these depressive symptoms, paired with my "euphoria" taking small doses of ritalin, he diagnosed me bipolar. Yes. The next two years are honestly difficult to remember with the various medications they tried on me. The most successful was lithium, but I then had to deal with my husband at the time accusing me of embarrassing him because I was so "spacey".

Eventually – I'm not sure why – I said "fuck this noise" and stopped taking the lithium. I had dumped my therapist (after he went on to try to diagnose me with the remainder of the DSM) and my psychiatrist monitored me while I went down to just Zoloft. Eventually, I left my husband, and without health insurance stopped taking that.

And now, it's been 5 years since I've been on meds. My mind is a little high-maintenance (I compare it to my car – a Mini) but it's worth it because it's an amazing machine. I'm finally understanding WHY my personality is this way and that, and what good things that can do for the world and my life.

Obviously all of our experiences are going to be so unique, but I have spoken with many women who have suffered similar stories – they start getting sucked into this medication cycle that wasn't necessary to begin with.

MamacitaConPistoles

A student of mine who had been through something similar called it "the next thing you know you're on a skittles bag of pills" phenomenon.

noodge4lyfe

I also wanted to edit my last paragraph to say:

Obviously all of our experiences are going to be so unique, but I have spoken with many women who have suffered similar stories – they start getting sucked into this medication cycle that wasn't necessary to begin with. I think there are many people who need medication to function fully and there is no shame or problem in that. But I think the psychiatric community jumps to that so quickly especially with women – their emotions and brains seem to be held up to the standard of men's brains – which obviously carries lots of questions of nature/nurture etc but it's fair to say that many women process emotions differently than men. MANY THOUGHTS, but I suppose my main point is: let's dig deeper, find the reasons for the depression and other psychiatric issues because they may be better treated without meds in the long-term.

fondue with cheddar

I just wanted to let you all (Rachel and the commenters) know that I enjoyed this post and am enjoying everyone's comments so far (I haven't had the time to read them all yet). Okay, "enjoy" isn't exactly the right word, but you get the idea. I've had depression for a long time and have had varying degrees of therapy/medication over the years. I'm currently in a low spot and am trying to figure out which path to take and how to actually get up and walk it. I don't have anything insightful to say, I just wanted to thank you all for being here and sharing your experiences. &lt;3

I think that the "real" conversation about depression is hard to have on a large scale. Here, it works. With a group of friends, it works. But on a mass media scale? I don't think so. Maybe it is possible, but I just don't see nuance coming out of mass media, which is what this topic requires.

I often can't even have a nuanced conversation with mental health care professionals because so many of them get so dogmatic about things. (I have had a lot of bad experiences with mental health care professionals and don't understand why, YMMV.) If the professionals, the experts, struggle with this, how is the general public expected to handle this? I've felt more stigmatized for my mental illness by professionals than by any other group of people, so knowledge and meaning well clearly isn't enough. We need both knowledge and nuance, maybe more, to have a "real" conversation about this and I feel like not everyone is capable of that.

Janejane

I have been on and off various anti-depressants most of my adult life. Today I had a really lousy day and I realized that I've been so happy lately due to a positive life change that I got really sloppy about taking my meds. Meanwhile I'm trying to burn off mounting anxiety with physical labour. Except after a few days the anxiety outlasted my physical capacity for work. And now I am anxious and angry and realizing, perhaps for the very first time in mt entire life, that I do need to be on these meds right now and most likely forever. Reading this article helped me see this.

askanaspergirl

I took Zoloft (sertraline, an SSRI) from an October to the following February. I have generalized anxiety disorder (oh GAD…), so persistent, interfering worry has been an issue for as long as I can remember (messy home life and unrecognized autism – so no supports for either – probably added to my psychosocial stressors). The sertraline eventually made me hypomanic. My psychiatrist at that time switched me to Klonopin (clonazepam) at that point, which worked through the summer, but then made me too sleepy. I gradually tapered off my dose. Not on meds at this point, but wonder if I'll be back on them in the future.

For me, meds have functioned like brain splints. They help me function long enough to actively participate in psychotherapy (I've been seeing the same therapist since I started taking meds), but their effects don't seem to stick particularly long. Their side effects have outweighed their benefits for me after a while. Therapy has helped immensely, but it wouldn't surprise me if I'm eventually taking another type of SSRI. I wrote a poem about this process: http://tmblr.co/ZoUris18RbZ1e

fondue with cheddar

Wow, a lot of what you are saying rings true to me. I had a similar experience when I separated from my ex and went on Wellbutrin. I was like, "Wow, is this what normal people feel like?" Eventually I sunk back down to what is my normal (which is not terrible but not that good, either), and since then have had a harder time dealing with it because now I have this happy-confident-clearheaded feeling to compare it to. I want to be that person again but I don't know if it's me. I think I've had some degree of depression since I was a child, so I don't even know what "healthy me" is like.